Control blood pressure to keep diseases at bay

Suruchi Tulsyan, THT,  13 Nov 2013: If you are among those who have given up taking medication for high blood pressure, be ware. You are perhaps inviting bigger trouble. High blood pressure is one of the important risk factors for life-threatening conditions like cardiac arrest, kidney failure and brain haemorrhage.
“A lot many people think it is alright to stop medication or not take any medication for their high BP if they ‘feel normal’. At times, these result in complications like intracranial haemorrhage, leading to death,” said Dr Debdatta Bhattacharya, chief of cardiology, Rabindranath Tagore International Institute of Cardiac Sciences.
It is also due to this reason that doctors in India take a holistic approach towards treating BP, taking into consideration a person’s age, medical history and lifestyle before they prescribe a treatment for it. The approach helps control the other diseases in a better way. A study on the US population on the same subject was published in medical journal, Circulation, recently, reinforcing the belief.
“Hypertension is a lifestyle disorder where both nature and nurture play a role. You can have BP as much due to genetic factors as well as due to reasons like obesity, wrong diet, high cholesterol, etc. Only giving medication for BP will not help. Depending on the individual case, we need to give protection to kidney, eyes, heart and other organs,” said Dr Subrata Maitra, general medicine expert.
“One’s BP can get compromised resulting in heart attack if he is given too much ACE inhibitor (a drug), or given beta-blocker in a condition that partial heart blockage occurs. Thus, it is important to consider the condition of one’s heart before prescribing medicines,” said Sukumar Mukherjee, consultant physician at CMRI.
Doctors are dealing with worrying statistics when it comes to identification and treatment of hypertension in the city.
“Over 25% people living in urban areas of the country have high BP. Over 80% of these cases are undiagnosed. Only 35% of the diagnosed cases have their BP under control,” said Dr Dhiman Kahali, senior consultant interventional cardiologist at BM Birla Heart Research Centre.
“In advanced countries, about 65% BP cases remain undiagnosed. Among those identified, only 1/3rd have a desirable level of BP of 140/90 millilitres of mercury, which is higher than the normal level of 120/80. There is a global trend of high BP, which needs to be controlled,” added Kahali.
High BP can also go unrecognised for many years altogether and prove fatal for the person. “People are not aware that a lifelong treatment is needed for BP. And, that a general physician near them, in place of a specialist, is the best to treat them for it. BP is a chronic illness for which long-term follow-up is required with the doctor. The good point thing is that it can generally be controlled by medicines,” said Bhattacharya.
There are four to five classes of BP medicines and what suits one best needs to be found by trial and error at first, says Bhattacharya. Plus, these need to be reviewed over time by the general physician.
“Another trend among patients is they start trying indigenous ways of controlling their BP and avoid medicines. I always say them, try what you want, but do not stop the medicines,” said Maitra.
While it becomes mandatory to use medication in high BP cases, Bhattacharya said that in case of young people with mildly high BP, they first try to control it with relaxation technique.
“Nowadays, people start having high BP in their mid-20s too. Since the medicines need to be taken lifelong once started, in the younger cases, we first prescribe controlling with relaxing techniques like meditation, exercise and healthy diet. When these don’t work, medicines are essential,” said Bhattacharya.
Kahali emphasised the role of salt intake in BP problems. “According to the WHO bulletin, if you reduce the salt intake per day to 5-6 gms in total, you reduce the chance of suffering from high BP. This also reduces the chances of suffering from heart attack, stroke, diabetes, etc,” he said. At present, on an average, Indians take 10-12 grams of salt daily.
He added that although it is not possible to remove the risk of suffering from any of these diseases totally, it is possible to delay their onset. “Regular exercise, walking etc, help by releasing sweat, which means loss of sodium from body. Regular salt we take in primarily has sodium in it, excess of which needs to be taken out of body,” said Kahali.
Among other important ways to keep hypertension at bay, he advised keeping stress levels under control, avoiding alcohol and intake of diet rich in protein (available in daily products) and potassium (in seasonal fruits). “Simple steps to keep BP in check go a long way to keep complications away when suffering from adverse diseases of heart, brain and kidney,” said Kahali.

BASIC KNOW-HOW ABOUT BLOOD PRESSURE

High blood pressure (or hypertension) is a lifestyle disease which requires lifelong medication The problem goes undiagnosed in over 80% cases in urban population. It is estimated that 25% of urban population have high BP In fact 25-year-old youths have started having BP and 15-17% of these cases are results of stress Those suffering from mildly high BP can get some help from relaxation techniques like meditation and exercise Stopping medication upon feeling ‘normal’ is unsafe. It can cause complications of heart, kidney, liver, eyes, brain and other vital organs Depending on age, BP level and chance of facing other diseases, medication for BP should be reviewed over time It is not advisable to resort to indigenous ways of controlling BP – like having food supplements and avoiding taking medicines A general physician, who is near your house and understands your history intimately, with whom you can share your lifestyle and problems freely, is a better person to treat BP than a specialist As per WHO, 5-6 gms salt per day keeps the disease at bay Calcium and potassium rich diet along with exercise and walking are other ways of keeping BP level normal